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目的:探讨绝经后早期内源性雄激素水平变化与胰岛素抵抗的相关性。方法:选取2010年3月~2013年11月于天津市滨海新区汉沽医院就诊的98例绝经后早期妇女作为研究对象,将体质指数(BMI)<24 kg/m2的妇女列为正常体质量组,将BMI≥24 kg/m2的妇女列为超重组,对两组妇女的空腹血糖水平、睾酮、硫酸脱氢表雄酮、性激素结合球蛋白以及空腹胰岛素水平进行检测,并计算游离雄激素指数以及稳态模型胰岛素抵抗指数,采用偏相相关分析法以及多因素logistic回归分析法对睾酮、硫酸脱氢表雄酮、性激素结合球蛋白、游离雄激素指数与胰岛素抵抗指数的相关性进行分析。结果:绝经后早期正常体质量组妇女其性激素结合球蛋白水平明显高于超重组妇女,而游离雄激素指数、空腹胰岛素水平以及稳态模型胰岛素抵抗指数则较超重组妇女明显降低;各指标间偏相关性分析结果显示,性激素结合球蛋白与空腹胰岛素水平以及稳态模型胰岛素抵抗指数呈负相关(P<0.05),硫酸脱氢表雄酮与稳态模型胰岛素抵抗指数呈正相关(P<0.05)。结论:妇女绝经后其胰岛素抵抗风险的增长与内源性雄激素水平的增长有关,且早期表现出性激素结合球蛋白与胰岛素抵抗风险增长呈负相关以及硫酸脱氢表雄酮与稳态模型胰岛素抵抗指数呈正相关的特点。
Objective: To investigate the relationship between endogenous androgen levels and insulin resistance in the early postmenopausal period. Methods: From March 2010 to November 2013, 98 early postmenopausal women treated in Hangu Hospital of Binhai New District of Tianjin were selected as the study subjects, and women with BMI <24 kg / m2 were selected as normal body weight group , Women with BMI≥24 kg / m2 were enrolled as overweight group. Fasting blood glucose, testosterone, DHEA, sex hormone binding globulin and fasting insulin were measured in both groups. Free androgenic index And the steady-state model of insulin resistance index. The correlation between testosterone, DHEA, sex hormone binding globulin, free androgen index and insulin resistance index was analyzed by partial correlation analysis and multivariate logistic regression analysis. Results: In the early postmenopausal women with normal body weight, the level of sex hormone binding globulin was significantly higher than those in the overweight group, but the free androgen index, fasting insulin and insulin resistance index were lower than those in the overweight group. Partial correlation analysis showed that there was a negative correlation between sex hormone binding globulin and fasting insulin levels and steady-state insulin resistance index (P <0.05), and there was a positive correlation between DHEA and insulin resistance index (P <0.05 ). CONCLUSIONS: The increased risk of insulin resistance in women after menopause is associated with an increase in endogenous androgen levels, and early evidence of a negative association between sex hormone binding globulin and the increased risk of insulin resistance and the association of DHEA and homeostasis model insulin Resistance index was positively correlated with the characteristics.